Medical Billing Forum

I have a Medicare patient that had Anthem BC/BS primary. Her Anthem BC/BS policy termd. The Medicare Common working file still show Anthem BC/BS primary. I believe in the past we were able to bill Medicare with a copy of the primary EOB showing the denial due to termination and get paid by Medicare. Our Medicare clerk is telling me we cannot bill this electronically because this has to be removed from the common working file first. Isn't there a way to bill Medicare with occurence codes electronically and receive pymt? Thanks for help!!

We had a similiar situation a year ago. The patient had to call Medicare herself and inform them that Medicare would now be primary. I believe she had to have the exact date the original BCBS plan terminated, and Medicare switched it on their computers. I then was able to get paid with MCR primary.

I agree when we have a Medicare patient that there primary insurance had termed I always contact the patient and ask them to call Medicare and have them update the national file to show Medicare primary and ask that they call me back once this has been done. Medicare will tell them that we can rebill in 10 days!

This seems to be common I had a patient who every New year her primary Blue Cross claims they need EOB's from medicare which is primary. Every year I have to call the patient so she can call Blue Cross to get them back in order. I am not sure why every year this happens to her!